The Affordable Care Act has made restaurants more partisan

Politics in the US is discouragingly partisan. National politics has become increasingly partisan since at least the late ’60s, when the passage of civil rights legislation influenced many conservative southern Democrats to join the Republican Party. Even state politics has become more partisan, where even famously nice people in Wisconsin have found themselves battling their neighbors across political divisions. Fortunately, most of life does not force us to confront our political differences, meaning we can go out to dinner with our family and friends, sharing space with other diners free from concern that we will be confronted with partisan rhetoric.

Until now.

According to a report on CNN Money, some restaurants in Florida are now making sure their patrons recognize the burdens being placed upon them by the Affordable Care Act. Here’s a copy of a receipt from one of these restaurants:

The Affordable Care Act has made restaurants more partisan

I find this disturbing for a whole host of reasons. The restaurant owner doesn’t choose to break the sales tax down, for example, to reflect which portion of that goes towards education, unemployment insurance, road maintenance, etc. The owner doesn’t inform customers how much cheaper their meal is as a result of federal subsidies to farmers. Instead, the owner singles out one, and only one, government program.

Which leads to what bothers me the most about this behavior — it politicizes a social and business setting that shouldn’t be politicized. Easy enough for those who object to this practice to boycott this restaurant. But in today’s climate, I expect that would only cause other people to be even more likely to go to such restaurants. What’s more, are we thereby forced to study the political allegiances of every consumer goods company we consider spending our money at? The restaurant chain Chick-fil-A already confronted this issue, when word got out about donations the company had made to oppose gay marriage. Mozilla, the company that makes the Firefox browser, ran into trouble when its new CEO was found to have donated money to oppose a gay marriage amendment. The CEO now stepped down. But before that happened, some people were urging computer users not to use that browser to signal their displeasure with the CEO’s political views.

Partisan politics is spreading from the corridors of Washington to innocent public spaces. I worry that this will further drive people apart from each other, people who have much in common with each other once they put their political differences aside. One of the strongest predictors of how much one person likes another person is proximity. We are already sorting ourselves into neighborhoods that strongly predict political affiliation. We flock to churches that match our political ideology. All of this sorting reduces the chance we will have casual encounters with people whose political beliefs differ significantly from our own. The behavior of these restaurant owners in Florida is aggravating this problem.

Are we heading towards a society where the choice of family restaurants must now be based upon our political allegiances?

Peter Ubel is a physician and behavioral scientist who blogs at his self-titled site, Peter Ubel and can be reached on Twitter @PeterUbel.  He is the author of Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices TogetherThis article originally appeared in Forbes.

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  • Dr. Drake Ramoray

    Politics becoming more partisan is a myth.

    Charles Sumner was attacked and caned in the senate in 1856.

    http://www.senate.gov/artandhistory/history/minute/The_Caning_of_Senator_Charles_Sumner.htm

    Also see the election for the presidency between John Adams and Thomas Jefferson in 1800.

    http://www.realclearhistory.com/articles/2012/03/10/adams-jefferson_ii_getting_nastier_7-full.html
    Your break down of the sales tax by what it goes to is nor practical and that information may not be readily available. If the restaurant has increased overhead for providing health insurance, I see no reason they can’t add it as an ACA tax if they choose to do so. Several of our vendors added a “fuel surchage” when gas prices were through the roof. Providing healthcare for employees is part of an overhead expense that gets factored into pricing.
    Lastly you have a poor understanding of political history if you think things are more partisan now.

  • Lisa

    My problem with the restaurant is that by pulling out their supposed ACA related costs and listing it with the sales tax, is that they are implying there is an actual surcharge or surtax. There is not. Furthermore, I suspect what they are doing is illegal. They are avoiding charging sales tax on the cost of the meal because the amount is tacked on the bill after the sales tax is calculated. I wonder if the Florida Board of Equalization is aware of the situation.

    • Dr. Drake Ramoray

      I am not an accountant or work for the IRS (thank goodness) but I did note the “fuel surcharge” I cited above was also charged after taxes. I am interested in that nuance as well but do not have an answer.

  • Patient Kit

    I think it’s safe to say that the vast majority of restaurants in the US do NOT provide health insurance for their employees. It would be interesting to know whether Gator’s Dockside is in the minority of restaurant businesses that does provide health insurance.

    • Dr. Drake Ramoray

      You raise a very valid point, and my original post is based on the assumption that they do provide health insurance. Obviously if this restaurant doest not they deserve all the bad press that can be mustered for the surtax.

      Health insurance for our employees has gotten so expensive we have started including individualized itemized benefits expenditures for each employee for when review/raise time comes up and raises are smaller than they have been in the past.

      • Patient Kit

        See my edit to my own post above. I got curious and answered my own question about which, if any, Gator’s Dockside employees get health insurance. The answer: currently, only management.

        I’m not unsympathetic about the costs of providing health insurance to employees, nor am I oblivious to what those costs are. I COBRA’d my own at $700/mo plan after my layoff for as long as I could.

        Personally, I would love to change to a single payer system and get rid of employee-based health insurance altogether. Right now, for most Americans health insurance comes from either employers or government. If not that, what? In this economy, with the class gap growing wider and wider, there is no possibility that we will ever go to “everybody just buy their own”. The vast majority of the population would just have to go without medical care if we didn’t have government and employee provided insurance.

        • Dr. Drake Ramoray

          Well my overhead would go down with single payer and I’m actually starting to get more hassles from private insurance companies than Medicare. I am not as opposed to single payer as some of my colleagues although my right to collectively bargain would need to be there for that proposal to be on the table.

          That being said if we went to single payer I could reduce my staff by 10-15% so we would have single payer but some of my employees would be looking for jobs because I no longer need as much staff to process insurance claims. This writ large across the country (not even including those who work for a private insurance company (I said workers not CEOs))would have a pretty detrimental effect on employment.

          My overall point is that the costs of doing business and the need for employees do not occur in a vacuum. I did note your comment about the cost of insurance to employees in your reply, but I think many people including the author of the original article don’t take these things into account.

          • Deceased MD

            Although no one likes to lay off employees, maybe the 10-15% could do something that would add real value to the economy then excessive admins in medicine. (I am sure they are good workers and help you get paid but surely with a less burdensome system….)

          • Dr. Drake Ramoray

            Don’t dispute that there is excessive admin or that I wouldn’t prefer a more streamlined system. I just think these are things the author of the original article doesn’t consider.

          • Deceased MD

            thanks. good point Drake

          • Patient Kit

            I understand that moving to a single payer system would eliminate a lot of insurane-related jobs. And I don’t take those job losses lightly. But those jobs are not a good enough reason to keep a very dysfunctional healthcare system. We’ve seen the loss of jobs in other whole industries as the world we live in changes. Look at manufacturing in this country. Look at the US post office. People who lose their jobs when major change decimates the whole sector they work in need help moving on to a new kind of job, like cross-training support.

            If we went single payer, I would definitely support doctors’ right to bargain collectively.

            As far as employees not knowing the cost of their health insurance to their employers, there is nothing wrong with employers giving their employees that info. It’s always part of the conversation when negotiating a union contract, during which wages/raises and health insurance are both always on the table.

            Do you have any sense of what percentage of doctors in private practice provide health insurance for all of their employees? I’d be curious to know what kind of benefits people get who work for independent docs.

          • Dr. Drake Ramoray

            Every private office in my community provides health insurance (at least that I’m aware of).

          • Patient Kit

            I’m very happy to hear that. I hate hearing about peeps who work anywhere in the healthcare system who don’t have access to good medical care themselves.

  • NewMexicoRam

    Get off your high horse, buddy.
    Your politics have found you out, so you lash out at those who are fed up with it.

  • guest

    I honestly don’t see anything particularly wrong with what the restaurant is doing. Many different types of people, including myself, are disappointed that instead of the single-payer healthcare reform that our country needs, what the ACA provides is taxpayer and employer-funded revenue maximization for private insurance companies.
    I am not sure that negative feelings about the ACA can be accurately attributed as “partisan,” although I recognize that many Democrats would like to portray things this way. I myself am a registered Democrat who voted for Obama in 2008.

    • Dr. Drake Ramoray

      Taxpayer and Employer Funded Revenue Maximization for Private Insurance Companies is a fantastic name for the bill. TEFRMPIC just doesn’t have the same ring to it. I bet it wouldn’t have gotten passed with that name though.

      • guest

        Actually, if you squint (or maybe have a couple of drinks), TEFRMPIC kind of looks like TERRIFIC…

        • Dr. Drake Ramoray

          LOL!

        • Patient Kit

          Squinting isn’t working for me. Maybe I’ll try tequila later. ;-)

          • guest

            I definitely recommend tequila over squinting…

    • Lisa

      1) By listing the ‘surcharge’ with the sales tax, the restaurant is implying there is an actual ACA surcharge, which there is not. 2) To me, it appears that they are collecting money from customers and not reporting it in their sales total. This means they would not be collecting sales tax on this money, which if it is part of the cost of food, they should be. 3) It also means they would not be paying income tax on an additional profit the restaurant has due to the surtax. Just wrong, imo…

      • guest

        OK, if that’s what they are doing I agree that sleazy accounting practices and tax evasion are wrong. However, what Dr. Ubel was talking about was more the divisive partisanship aspect.

        • Lisa

          I understand. But if you are going to engage in politics, at least be honest about it.

      • http://onhealthtech.blogspot.com Margalit Gur-Arie

        It’s like a tip… gratuity is added after tax… I guess patrons are required to show their gratitude for Obamacare to the tune of 20 cents….

        • Lisa

          Employees are taxed on the imputed value of tips (If I remember correctly, tips are assumed to be 8% of sales). Is the restaurant including the surcharge in their income?

          • http://onhealthtech.blogspot.com Margalit Gur-Arie

            I have no idea, but it’s got to be on the books if it’s on the receipt, no?

          • Lisa

            It may be on the books, but what is important is how it is treated. Is it classified as income, is it classified as a sale? Are they paying the appropriate taxes. To me it seems like they are collecting more money, under the cover a making a political statement and probably not paying taxes. Bah….

  • John C. Key MD

    I’m afraid the estimable Doctor Ubel has been in a dream world if he feels that any of this is new; it’s as old as mankind. The caning of Sumner occurred decades after the Hamilton-Burr duel. Partisanship in recent decades got most toxic during the Bush 43 years, and President Obama, as he is wont to do, has “doubled down” on it in his years.

    An “ACA surtax” is surely the most innocuous of these problems. Dr. Ubel may as well admit that, at least at this time, the ACA is unpopular with a majority of Americans.

  • ninguem

    One reason other countries like the VAT is because it makes it easier to hide the tax.

    It’s more visible this way.

    And maybe it would be just as well to break down that sales tax into what pays for roads and schools and graft.

    So “obamacare surcharge”, fine with me, but they better have the bookkeeping done right, as pointed out elsewhere on this thread.

  • medicontheedge

    This has less to do with actual costs, as it does the petty, greedy, mean-spirited, in your face political spite of the right wing lunatics.

  • Ava Marie Wensko George

    I agree. If they are going political and adding an ACA surtax first PAY THEIR EMPLOYEES A LIVING WAGE. Then, outline every other tax (State, Local, and Federal) that they personally pay. Also, let’s get a little bit more ridiculous and list the wages their employees make per hour (not including tips), because if we want to get really granular, the restaurant association has been receiving a subsidy from the Federal Government for paying their employees 1 to 2 dollars an hour for decades. I agree with Dr. Ramoray, they have always been partisan. They just choose what they want to share as burdensome and neglect to add all the benefits they receive from you and me.

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